PETALING JAYA, Selangor – With the emergency departments of some Malaysian government hospitals bursting at the seams, some doctors have said that the wait for beds can stretch to two days or more.
Speaking to The Star newspaper on condition of anonymity, these doctors say the shortage of inpatient beds, overstretched resources and a manpower crunch are the cocktail of reasons driving up the congestion at hospitals.
At a government hospital in Sabah, an emergency physician said the wait time could go up to two days and stretch to beyond four to five on bad days.
“The main cause is there are insufficient inpatient beds. Therefore, patients have to wait in the emergency department to be admitted,” the doctor said.
While patient deaths cannot be attributed to the long wait, it does indirectly contribute to further deterioration of the condition of patients.
“Indirectly, I would say, it is possible,” the doctor said. “For instance, the lack of intensive care unit (ICU) beds means that patients stay longer in the emergency department rather than being transferred to the ICU, where they will get better care.”
However, the patients are treated while they wait for beds.
The emergency department crowd could get worse during a dengue outbreak, festive seasons, school holidays and long weekends.
At a hospital in Kuala Lumpur, a doctor said the emergency department was already crowded.
“The waiting time for patients to be seen can go up to three hours, but waiting for admission can be more than a day,” he said.
“Government hospitals deal with multiple problems. This does not only include clinical issues but also poor infrastructure, lack of human resources, social issues and even a lack of specialists.
“For a mere RM1 (31 Singapore cents), a patient can be registered at the emergency department to wait to be seen. If admitted, then the patient is admitted to a ward.
“However, there may be pending admissions that require more critical care. Thus, a patient may end up waiting longer at the emergency department as beds are limited, and at times, patients are managed in different wards,” he said.
He said that while specialist care was given once a patient was admitted to a ward, some patients might require further intervention and sub-specialist reviews.
“In terms of specialist care, some hospitals don’t even have enough medical officers and house officers, so the discharge process is delayed. Once the patient is scheduled to be discharged, some families refuse to answer calls or take their family member back home. Now it has become a social issue,” he added.
He said staff quit when they become overburdened and can no longer manage.
“This cycle repeats itself, but statistics often are portrayed differently,” said the doctor.
“For example, if a patient is admitted for a surgical procedure and the specific surgical treatment is delayed, what can be done is to put the patient on an intravenous drip or give medication first. Sometimes, there is a treatment delay due to an overload of patients.”
Patients and their next of kin have taken to social media to share their experiences with delays in getting a bed at hospitals, an issue that some have alleged has claimed lives.
Dr Muruga Raj Rajathurai, president of the Malaysian Medical Association, said the whole emergency department system needed to be looked into, and this would involve human resources, facilities and the admission system of each public hospital to address the overcrowding at emergency departments, manpower issues, and unavailability of beds.
“The Ministry of Health will have the necessary data to address these issues and we believe they are being looked into as the Health Minister (Dr Zaliha Mustafa) has stated her strong commitment to addressing the issue of overcrowding at public healthcare facilities,” he said.
He added that while it was known that the country has been underspending on healthcare, the government must ensure there are enough beds at hospitals.
On Jan 22, Dr Zaliha said her ministry would seek comprehensive solutions with stakeholders to address the issue of overcrowding at hospital emergency departments.
The minister said possible solutions included extending working hours, streamlining bed management systems, and increasing the number of healthcare providers. THE STAR/ASIA NEWS NETWORK